74th Annual PIA Convention & Tradeshow

Agency / Company Name: *

Attendee Name: *

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Last

Address: *

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Phone: *

Spouse or Guests Attendee Names:

Children Attendee Names:

Member: $245

Non-Member: $300

Spouse / Guest: $150

Children: $75x **Free if 10 years or younger**

Golf: $115x (Before 3/22) (After 3/22 - $130)

**Includes greens fee, half-cart, snacks, beverages & lunch**

GRAND TOTAL:

$ 0.00

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THE CHANCELLOR HOTEL PIA ROOM BLOCK